Tornado victims' care scrutinized

Aug. 18, 2011

Written by

News-Leader

Federal disease researchers trying to learn why Joplin had the only cases of fungal infections reported after a tornado in the United States are studying, among other things, the medical care they received.

Emails among state and federal researchers reveal that investigators were trying to identify where people injured in the tornado first sought medical care.

"Idea here is to relate it to systemic issues at these care facilities (e.g., maybe Joplin hospital had only medical tent, ran out of betadine for 6 hrs one day, etc.), and duration from injury to seeking medical care," wrote Dr. Benjamin Park, who leads an epidemiology team at the U.S. Centers for Disease Control and Prevention. "...Would be helpful to talk to first responders to get a picture of what medical/trauma care was like immediately after tornado."

Spokeswomen for the two hospitals in Joplin, the St. John's hospital and Freeman, referred questions to state or federal officials looking into the cases. The St. John's hospital was destroyed by the tornado. Doctors from St. John's helped treat patients at Freeman and at makeshift facilities.

"Care was provided in tens of places by hundreds of health care providers in the days after the storm," said St. John's spokeswoman Cora Scott.

The team from the CDC issued a preliminary two-page report last month on the aggressive fungal infection known as mucormycosis. The 13 people who became sick were infected by the Apophysomyces trapeziformis species of fungus. All 13 underwent surgery to remove debris from the tornado or the fungus from their bodies. Five of them died, although their deaths haven't been conclusively tied to the fungus.

Robyn Neblett Fanfair, one of the authors of the CDC report, said in an interview last week that preliminary indications were that management of the victims' wounds was appropriate.

"All of the wounds were very dirty," Fanfair said.

D.K. Raymer, the executive director of a Springfield patient advocacy group called HealthCare PSI, said in an interview Wednesday that there have been more than 1,690 tornadoes in the United States this year and questioned whether hygiene problems in medical care were linked to the infections in Joplin.

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"Not one of the others has had any sort of fungal infection associated with the tornadoes," Raymer said. "Why did it show up here?"

The medical care provided after the tornado is only one of many factors investigators are looking into. Researchers are also looking at where people were when they were injured and what medications they were taking before the tornado.

Relatives of people who became sick with fungal infections were divided on the quality of the care they received.

Rebecca Newton, whose daughter Nicole Pearish died June 4 at age 23 at the University of Missouri hospital in Columbia, questioned why doctors were removing debris from the tornado from her daughter two weeks after the tornado.

"I think she was working on going septic when she went to Columbia, but the people in Joplin said she was stable," Newton told the News-Leader on Wednesday.

But Pearish's father, Steve Pearish, said his daughter's medical care was top-notch.

"The doctors in Joplin, Missouri, I commend them," he said. "They gave me 14 more days with my daughter that I wouldn't have had if they hadn't been there."